Ultrasound imaging apparatus with image selector

ABSTRACT

An ultrasound imaging system includes a cine buffer in which image frames produced during an examination are stored. A processor is programmed to select one or more image frames from the cine buffer for presentation to an operator for approval and inclusion in a patient record or other report. The operator can accept the proposed image frames or can select one or more other image frames from the cine buffer. The processor may select image frames at spaced intervals in the cine buffer for presentation. Alternatively, the processor compares image frames in the cine buffer with one or more target image frames. Image frames that are similar to the target image frames are presented to the operator to confirm. Alternatively, image frames can be selected by the processor that contain a specific feature or that are similar to image frames that were previously selected by the operator when performing a particular type of examination.

This application is a continuation of co-pending U.S. application Ser.No. 15/214,838 filed Jul. 20, 2016, which is incorporated herein byreference.

TECHNICAL FIELD

The disclosed technology relates to ultrasound imaging systems, and inparticular to systems for improving workflow within clinical settingsusing ultrasound imaging systems.

BACKGROUND

In ultrasound imaging, an operator of a system uses a probe to obtainultrasound images of a patient. The images captured by the system may beviewed, printed or included in a patient report for diagnosis and recordkeeping. In addition, select images may be included in a report that isused to bill the patient or their insurance for the services rendered.

Depending on the examination procedure being performed, the number andsubject of the images required in a report of the examination may bestandardized or defined. For example, an internal exploratory scan mayrequire that images of the patient's liver, bladder, intestines, kidneysand stomach be obtained. Similarly, a pre-natal scan may require imagesand measurements of various anatomic structures of a fetus. In a typicalsingle operator examination, a physician or an ultrasound technicianuses the imaging system to obtain all the images needed to complete theexamination. These images are typically selected by the user during theexam, stored in a buffer memory and must be reviewed after theexamination is complete to mark or otherwise identify images to be usedin creating a record of the scan. In the case of a procedure, such as anultrasound-guided regional anesthesia injection, where the care providercannot stop mid procedure or has no free hands to control the system, asecond person may assist in controlling the system settings andcollecting the needed images during the procedure.

SUMMARY

To improve on the systems described above, the disclosed technologyrelates to an imaging system that includes a cine buffer memory to storeimage frames as they are produced by the imaging system. A processoranalyzes the image frames stored in the cine buffer and presents one ormore selected image frames to the operator for approval. In oneembodiment, the image frames selected are image frames that are obtainedat equal time intervals during the examination. Alternatively, the imageframes may be selected by comparing the image frames in the cine bufferwith one or more target image frames. The target image frames may bedetermined by the type of scanning procedure being performed, based onprevious operator selections when performing the same or similar type ofscanning procedure. In another embodiment, image frames that arepresented are selected by determining whether the image frames meet aparticular quality metric, such as where a measurement is most clearlyseen or image frames that contain a particular anatomical structure orinterventional instrument (e.g., a needle), or are obtained at aparticular point in an examination procedure, in one embodiment, imageframes are selected for presentation based on how different the imageframes are from previous image frames stored in the cine buffer.

A programmed processor in the imaging system allows an operator toapprove the selection of one or more of the presented images forinclusion in a report or summary of the scanning procedure.Alternatively, the operator can select their own images by, for examplestepping through and selecting one or more image frames stored in thecine buffer. Optionally, the operator can make measurements on theseselected image frames before storing them depending on the clinicalprotocol for the targeted exam/procedure.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a block diagram of an ultrasound imaging system inaccordance with one embodiment of the disclosed technology;

FIG. 2 illustrates a programmed processor that is configured to selectimage frames from a cine buffer memory for presentation to a operator inaccordance with an embodiment of the disclosed technology; and

FIG. 3A and 3B illustrate two different methods of selecting imageframes from a cine buffer in accordance with the disclosed technology.

DETAILED DESCRIPTION

As described above, the disclosed technology relates to imaging systemsand in particular to ultrasound imaging systems. In some describedembodiments, an ultrasound imaging system includes a programmedprocessor that is configured to select one or more image frames that arecaptured during an examination of a patient. An operator can approve theselected image frames or can choose alternative image frames. Once theimage frames are approved, the processor can mark or otherwise designatethe approved image frames for inclusion in a report of the examinationfor the patient's records and/or for billing purposes. Although thedisclosed technology is illustrated in connection with an ultrasoundimaging system, it will be appreciated that the technology can beemployed with other types of imaging systems such as, but not limitedto, MRI systems, video endoscopy systems or other medical imagingsystems that capture many images during an examination procedure.

As shown in FIG. 1, a simplified block diagram of an ultrasound imagingsystem 100 includes a transducer 102 that is configured to sendultrasound signals into a body and to detect the corresponding echosignals. The transducer 102 may be a single-element transducer or mayconsist of one- or two-dimensional linear or phased array of transducerelements. The transducer 102 may be connected to a high voltagemultiplexer/de-multiplexer (HV mux/demux) 104 that is used selectindividual or groups of transducer elements in the transducer 102. Inthe case of a phased-array, signals to be transmitted by the transducer102 are generated by a transmit beamformer 105 that adjusts the timingof the signals in order to direct the signals in a particular directionand to focus the signals at a particular depth in the tissue.Alternatively, unfocused (plane) waves can be transmitted by thetransducer. Signals from the transmit beamformer 106 are amplified byone or more high-voltage amplifiers 108 before being applied to the HVmux/demux 104 and the transducer 102.

A transmit/receive (T/R) switch 110 operates to disconnect the receiveelectronics of the ultrasound system from the transducer when the higherpowered transmit pulses are being transmitted. The T/R switch 110 isclosed when the imaging system is to detect the returning echo signals.Signals received by the T/R switch 112 are amplified by low-noisereceive amplifiers 112 that implement a gain function that typicallyvaries according to the depth from which the echo signals originate. Fora directional ultrasound system, the outputs of the receive amplifiers112 feed a receive beamformer 114 that delays and sums the amplifiedreceived echo signals. In most ultrasound systems, the analog receivedsignals are converted to corresponding digital signals, afteramplification, with a number of analog to digital converters (not shown)that are positioned between the receive amplifiers 112 and a receivebeamformer 114 in the signal path.

In one embodiment, a system processor 116, which could be implemented asone or more programmed microprocessors, is configured to execute programinstructions that are stored in an internal or external computerreadable memory (not shown) to control the operation of the ultrasoundimaging system.

Beamformed ultrasound signals produced by the receive beamformer 114 aredelivered to an image processor 118. The image processor 118, which mayinclude one or more general purpose microprocessors (including thesystem processor 116), one or more digital signal processors (DSP), oneor more graphics processor units (GPU), application-specific integratedcircuits (ASIC) or the like, converts the raw, bearnformed signals intoa two-dimensional image frame of pixel data that can be stored in memoryand shown to an operator on a video monitor or other display 124. Theimage frames produced by the image processor 118 are stored in a buffermemory 120 (also known as a cine buffer), which in one embodiment isoperated as a circular buffer of memory elements that stores a selectnumber of frames as they are produced during an examination. In oneembodiment, the cine buffer 120 can store 2-5 minutes of data at 30frames/sec or 3600-9000 image frames of ultrasound data or more. In oneembodiment, once the cine buffer 120 is full, the oldest image frame inthe buffer is overwritten with a new image frame in a circular fashion.A memory 126 is used to store the image frames for archival purposes.The contents of the memory 126 may be transferred to a remote patientrecords keeping system after an examination is complete. In someembodiments, at least some of the image frames that are stored in thememory 126 are compressed to save space and therefore may lack somedetail compared with the image frames that are stored in the cine buffer120.

A number of operator inputs 130 such as keys, buttons, knobs, voicecommands, gestures or software-configured controls, such as touch screencontrols or the like, allow an operator to change the operatingcharacteristics of the ultrasound machine and to input commands to thesystem processor 116.

In one embodiment, an operator begins an ultrasound examinationprocedure by using the input controls 130 to select an examination typefrom a number of pre-defined examination procedures that are shown onthe display 124 or may have a dedicated control on a keyboard of thesystem. Exemplary types of examinations may include an internal organexploratory scan, a neonatal scan, a cardiac scan, a carotid artery scanetc. Each of these scan types may be associated with particular viewsand measurements that are to be captured by the ultrasound machineoperator. For example, a neonatal scan may require views andmeasurements of a baby's heart, neck tissue, femur length and otherviews and measurements. In one embodiment, the views and measurementsrequired by the various examination types are stored in a knowledge basewithin a memory of the ultrasound system.

The operator uses a control 130 (e.g. an on-screen button, footswitch,control on an imaging probe etc.) to start the ultrasound machinecapturing ultrasound image frames. These image frames are produced andstored in the cine buffer 120 until the operator uses a control 130 tohalt the imaging process. As will be appreciated, the cine buffer isconstructed to store several thousand image frames of ultrasound data.In the past, the operator had to review/search through all of the storedimage frames to select which frames would be included in a patient'srecord and/or submitted for billing purposes.

To aid an operator in selecting one or more of the image frames, aprocessor such as the system processor 116, a DSP or a GPU executes anumber of programmed instructions to analyze the image frames that arestored in the cine buffer 120 and to select one or more image frames aspossible frames for review and approval by an operator. The selectedimage frames are displayed for the operator and the operator can eitherapprove the selection or can select different image frames. In oneembodiment, the approved image frames are marked for inclusion in apatient report of an examination, for use in billing, or both. In oneembodiment, the approved image frames are stored in the memory 126 withlossless compression or with little or no compression compared to theunselected or non-approved images frames generated during theexamination in order to retain more image detail.

FIG. 2 illustrates a display 140 in which the system processor 116 hasselected and presented a number of possible image frames 150 a, 150 b,150 c, 150 d for the operator to review and approve. The presented imageframes are shown to the operator on the display 124 and operator canapprove one or more of the displayed image frames for inclusion in apatient or billing report. Alternatively, the operator can select one ormore other image frames for inclusion into the reports if the operatordoes not like the image frames that have been selected by the systemprocessor 116. In one embodiment, the operator can view image framesthat were recorded in the cine buffer near any of the displayed imageframes by selecting, for example, image frame 150 c on the display 124.In one embodiment, the system processor 116 determines the address ofthe selected image frame by for example, recalling an index pointer 160that is associated with the image frame 150 c and that indicates theaddress of the image frame in the cine buffer 120. The system processorthen uses the determined address to recall and display a number of imageframes from the cine buffer that are stored just before and/or justafter the selected image frame 150 c. By using an advance or rewindcontrol on the operator inputs 130, the operator can view frames thatare recorded before or after the image frame 150 c. In this manner, theoperator can select an image frame that may show a desired view ormeasurement in a way that is better or more dear than is shown in theimage frame 150 c that was selected by the system processor 116.

The system processor can select image frames in a number of differentmanners or in accordance with a number of different metrics. In oneembodiment, the system processor selects image frames that are equallyspaced in the cine buffer for display to the user. For example, if anexamination generates 2000 image frames that are stored in the cinebuffer 120, the system processor may select image frames numbered 500,1000, 1500 and 2000 as the image frames that can be approved forpossible inclusion into the patient reports. The number of frames thatare initially selected may be chosen by the operator or may be definedby the procedure type.

In one embodiment, a knowledge base 170 is maintained on a computerreadable, media that may be internal to the ultrasound machine or may beaccessible by the system processor 116 by a wired or wirelesscommunication link. The system processor recalls parameters from theknowledge base 170 that are associated with the examination type that isin progress. These parameters can include such things as the number ofimage frames to be included in a report about the procedure, the viewsdesired in each of the image frames or the measurements desired in animage frame. For example, a nerve block procedure may require three ormore different image frames to be recorded that include views of aneedle approaching a target nerve, the needle at the position of thetarget nerve and anesthetic being delivered around the target nerve.

In one embodiment, an image database 180 is maintained on a computerreadable media that may be internal to the ultrasound machine or may beaccessible by the system processor 116 by a wired or wirelesscommunication link. The image database 180 stores representative imageframes that show various anatomical structures that can be comparedagainst an image frame that is stored in the cine buffer in order todetect a match. For example, if a procedure requires an image of apatient's liver in a particular orientation, the image database 180includes an image frame that is coded as representing a liver in aparticular orientation and that is required by a particular type ofexamination. If the operator is performing a liver scan procedure, thesystem processor recalls one or more of the target image frames from thedatabase 180 and compares the target image frames with the image framesthat are stored in the cine buffer to identify those image frames thatmost closely match the target image frames.

In some embodiments, the target image frames are associated withnarrative information about the frame. The narrative information mayinclude the type of tissue being imaged and one or more parameters ofthe ultrasound machine used to obtain the image. Such parameters caninclude the operating mode of the ultrasound machine (B-mode, DopplerMode, Power mode etc.) as well as power settings, pulse repetition rate,focal depth, probe used etc. The system processor can pre-populate anarrative associated with the selected image frame using thecorresponding operating parameters of the ultrasound machine that wereused to obtain the image frame so that the operator doesn't have toenter the narrative values manually.

In some embodiments, the processor may execute instructions that performa machine learning algorithm to compare image frames stored in the cinebuffer with image frames that were selected by the operator for aprevious examination. Those image frames that bear the closestresemblance to the previously selected image frames can be presented tothe operator for possible inclusion into the patient report or billingrecord (or other report). In this way, the processor can predict likelyimages that will be selected based on the user's previous actions insome embodiments, the processor executes instructions to determine whichimages require measurements to be taken and cause the processor todisplay a graphic representing a caliper or other measurement tool onthe images. The placement of the caliper graphic can be based on animage recognition of the anatomical features contained in the images.For example, an image of a femur can be analyzed and the processor candisplay the graphic representing the caliper along the length of thefemur (or across the femur width if that is the measurement to bedetected). The user can use the position of the caliper to obtain atissue measurement or can vary the location of the caliper if theydesire.

FIGS. 3a and 3b show two possible alternative methods of selecting imageframes for approval by an operator of the ultrasound processing system.As shown in FIG. 3a , a cine buffer 120 stores a number of frames F1-FNthat are stored when the examination first begins, and continues untilthe examination ends. The system processor is configured to executeprogramed steps to determine the number of frames stored in the cinebuffer for the particular examination. In one embodiment, the systemprocessor keeps an internal count that is increased each time an imageframe is added to the cine buffer. The system processor also keeps arecord of the first memory address in the cine buffer that stores afirst image frame for the current examination. The desired number ofimage frames to be presented for approval by the operator is eitherreceived from the operator or from the parameters associated with theparticular type of examination being performed. In one embodiment, thesystem processor divides the total number of frames stored in the cinebuffer by the number of image frames desired uses the result todetermine the address of the equally spaced image frames in the cinebuffer. In yet another embodiment, the system processor keeps a recordof the first address used in the cine buffer and subtracts the firstaddress from the last address used to store an image frame in the cinebuffer for an examination. The result is the number of memory addressesused to store the image frames in the cine buffer. An index into thecine buffer for the equally spaced image frames can be determined by theprocessor based on the first and last address, the number of memoryaddresses used by each image frame (assumed to be the same for eachimage frame) and the number of image frames desired to be presented.

In an alternative embodiment, the system processor 116 or other imageprocessor analyzes the image frames stored in the cine buffer for one ormore image frames that bear the closest resemblance to one or moretarget image frames associated with the examination being performed. Inone embodiment, the system processor 116 is configured to executeprogram instructions to determine the number and type of image framesthat are required by a particular type of examination from the knowledgebase 170. The system processor then recalls one or more target imageframes from the image database 180. Image frames in the cine buffer 120are then compared to the target image frames to find the closestmatches. The closest matches are then presented to the operator forapproval.

There are a number of well-known image comparison techniques that can beused by the system processor to compare the image frames in the cinebuffer with a target image frame. For example, a simple least squarescomparison of the pixel brightness for the pixels in an image framestored in the cine buffer memory and the target image frames can beused. In another embodiment, image frames can be classified by ahistogram of brightness values and a comparison made to determine if thetwo histograms are similar. In yet another embodiment, two-dimensionalFourier transforms of the image frames are compared to determine howsimilar the image frames are. Other more complicated and well-knownimage comparison algorithms such as SIFT, PCA-SIFT and SURF could alsobe used to compare image frames. Image frames that most closely matchthe target image frames are selected and presented to the operator toapprove or reject.

If an examination requires imaging different portions of the body, thenthe proposed image frames can be selected by the system processor basedon how different the image frames are. For example, if an examination isto image the heart, lungs and liver, the procedure begins by obtainingimage frames of the heart which should look fairly similar to eachother. Once the operator begins imaging another part of the body such asthe lungs, the image frames will look quite different from the imageframes of the heart. The system processor therefore executes programinstructions that compare sequential frames from the cine buffer andselects an image frame that differs significantly from a previous frame.The sequential image frame comparison may also be used in conjunctionwith a comparison against one or more target image frames recalled fromthe image database. For example, if an examination starts with imagingthe heart and then moves to the lungs, the first frame that lookssubstantially different than the image frames of the heart may becompared to a target image frame of a lung. Subsequent frames can alsobe compared to the target image frame of the lung so that not everyframe in the cine buffer need be compared with the target frame.

In yet another embodiment, the ultrasound system stores locally orrecalls from a remote computer system, image frames that were selectedby the operator on one or more previous occasions when the operatorperformed the same type of ultrasound examination that is currentlybeing performed. The previously selected image frames are then used astarget image frames for comparison against the image frames that arestored in the cine buffer. Those image frames that bear the closestresemblance to the previously selected target image frames are presentedby the system processor for the operator to approve or reject.

In yet another embodiment, the system processor analyzes the imageframes stored in the cine buffer for the presence of an object. Theobject can be an anatomical structure such as a particular portion ofthe heart, a particular organ or portion thereof (e.g. a liver) whoseultrasound image can be characterized by shape or by echocharacteristics. Alternatively, the object can be a surgical instrument,such as a needle, or drug such as anesthetic, that can be detected in animage based on its shape or echo characteristics. For example, needledetection typically involves the detection of a bright reflector in alinear path within an image frame. The image frames in the cine bufferthat contain the object are presented to the operator for approval orrejection.

In yet another embodiment, image frames are selected that meet somepredefined image criteria. For example if an image of a heart valveneeds to occupy a certain size in an image frame, then the imageprocessor can analyze the images for the presence of the heart valve andcan calculate whether the size of the heart valve in the image meets thepredefined criteria. If an image frame meets both these criteria, theimage frame is presented to the operator for approval or rejection.Other image criteria such a Doppler measurement that exceeds or is belowa threshold could also be used.

In yet another embodiment, image frames are selected that were obtainedwith some defined operating criteria of the ultrasound machine. Forexample, image frames may be required where the image depth is between 5and 7 cm. If the image frames are recorded with meta data in the cinebuffer that indicates the depth of focus, then the system processor, orother image processor, can select one or more image frames that wereobtained at the desired depth of focus. Other imaging parameters caninclude power level of signals applied to the transducer or othercharacteristics that can be modified to obtain an image frame and arerecorded by the ultrasound system.

Once the proposed image frames are identified, the image frames arepresented to the operator. The operator can accept or reject theproposed image frames for inclusion in a patient or billing report. Ifone or more of the proposed the frames are rejected, the operator canselect another frame(s) by browsing the frames stored in the cinebuffer. As indicated above, in one embodiment, the operator can jump toa location in the cine buffer by selecting a proposed frame in order toview the image frames stored before and after the proposed image frame.The ultrasound system also provides the operator with one or morehardware or software controls by which the operator can scroll throughthe cine buffer in a manner similar to a video (e.g. run, pause, stop,fast forward, rewind etc.) and a control to select an image frame.

Image frames that are accepted are marked by the system processor forinclusion in a patient or other report. Marking can be performed in avariety of manners such as by changing meta data associated with animage frame. Alternatively, the system processor can keep a list ofimage frames associated with a particular examination that are to beincluded in a patient or other report.

In one embodiment, once the selected image frames have been identified,the image frames (which may or may not include the non-selected imageframes) can be stored in the memory 126 or other memory for archivalpurposes. In one embodiment, the selected image frames are stored with agreater resolution than the non-selected frames to preserve as muchdetail as possible in the selected frames.

Embodiments of the subject matter and the operations described in thisspecification can be implemented in digital electronic circuitry, or incomputer software, firmware, or hardware, including the structuresdisclosed in this specification and their structural equivalents, or incombinations of one or more of them. Embodiments of the subject matterdescribed in this specification can be implemented as one or morecomputer programs, i.e., one or more modules of computer programinstructions, encoded on computer storage medium for execution by, or tocontrol the operation of, data processing apparatus.

A computer storage medium can be, or can be included in, acomputer-readable storage device, a computer-readable storage substrate,a random or serial access memory array or device, or a combination ofone or more of them. Moreover, while a computer storage medium is not apropagated signal, a computer storage medium can be a source ordestination of computer program instructions encoded in anartificially-generated propagated signal. The computer storage mediumalso can be, or can be included in, one or more separate physicalcomponents or media (e.g., multiple CDs, disks, or other storagedevices). The operations described in this specification can beimplemented as operations performed by a data processing apparatus ondata stored on one or more computer-readable storage devices or receivedfrom other sources.

The term “processor” encompasses ail kinds of apparatus, devices, andmachines for processing data, including by way of example a programmableprocessor, a computer, a system on a chip, or multiple ones, orcombinations, of the foregoing. The apparatus can include specialpurpose logic circuitry, e.g., an FPGA (field programmable gate array)or an ASC (application-specific integrated circuit). The apparatus alsocan include, in addition to hardware, code that creates an executionenvironment for the computer program in question, e.g., code thatconstitutes processor firmware, a protocol stack, a database managementsystem, an operating system, a cross-platform runtime environment, avirtual machine, or a combination of one or more of them. The apparatusand execution environment can realize various different computing modelinfrastructures, such as web services, distributed computing and gridcomputing infrastructures.

A computer program (also known as a program, software, softwareapplication, script, or code) can be written in any form of programminglanguage, including compiled or interpreted languages, declarative orprocedural languages, and it can be deployed in any form, including as astand-alone program or as a module, component, subroutine, object, orother unit suitable for use in a computing environment. A computerprogram may, but need not, correspond to a file in a file system. Aprogram can be stored in a portion of a file that holds other programsor data (e.g., one or more scripts stored in a markup languagedocument), in a single file dedicated to the program in question, or inmultiple coordinated files (e.g., files that store one or more modules,sub-programs, or portions of code). A computer program can be deployedto be executed on one computer or on multiple computers that are locatedat one site or distributed across multiple sites and interconnected by acommunication network.

The processes and logic flows described in this specification can beperformed by one or more programmable processors executing one or morecomputer programs to perform actions by operating on input data andgenerating output. The processes and logic flows can also be performedby, and apparatus can also be implemented as, special purpose logiccircuitry, e.g., an FPGA (field programmable gate array) or an ASIC(application-specific integrated circuit).

Processors suitable for the execution of a computer program include, byway of example, both general and special purpose microprocessors, andany one or more processors of any kind of digital computer. Generally, aprocessor will receive instructions and data from a read-only memory ora random access memory or both. The essential elements of a computer area processor for performing actions in accordance with instructions andone or more memory devices for storing instructions and data. Generally,a computer will also include, or be operatively coupled to receive datafrom or transfer data to, or both, one or more mass storage devices forstoring data, e.g., magnetic, magneto-optical disks, or optical disks.Devices suitable for storing computer program instructions and datainclude all forms of non-volatile memory, media and memory devices,including by way of example semiconductor memory devices, e.g., EPROM,EEPROM, and flash memory devices; magnetic disks, e.g., internal harddisks or removable disks; magneto-optical disks; and CD-ROM and DVD-ROMdisks. The processor and the memory can be supplemented by, orincorporated in, special purpose logic circuitry.

To provide for interaction with a user, embodiments of the subjectmatter described in this specification can be implemented on a imagingsystem having a display device, e.g., an LCD (liquid crystal display),LED (light emitting diode), or OLED (organic light emitting diode)monitor, for displaying information to the operator and a keyboard and apointing device, e.g., a mouse or a trackball, by which the operator canprovide input to the computer. In some implementations, a touch screencan be used to display information and to receive input from a user.Other kinds of devices can be used to provide for interaction with aoperator as well; for example, feedback provided to the operator can beany form of sensory feedback, e.g., visual feedback, auditory feedback,or tactile feedback; and input from the operator can be received in anyform, including acoustic, speech, or tactile input. In addition, acomputer can interact with an operator by sending documents to andreceiving documents from a device that is used by the user; for example,by sending web pages to a web browser on a user's client device inresponse to requests received from the web browser.

From the foregoing, it will be appreciated that specific embodiments ofthe invention have been described herein for purposes of illustration,but that various modifications may be made without deviating from thespirit and scope of the invention. Accordingly, the invention is notlimited except as by the appended claims.

I/We claim:
 1. An ultrasound imaging system comprising: a transducerthat is configured to transmit ultrasound signals to and receiveultrasound signals from a region of interest; a receive circuitry thatis configured to convert the received ultrasound signals into firstimage frames of ultrasound data; a display to display the first imageframes of ultrasound data; a cine buffer to store the first image framesof ultrasound data produced during an examination; and a processor thatis configured to receive an indication of a type of examination beingperformed by the operator; recall one or more target image frames basedon the type of examination performed by the operator; and compare thefirst image frames that are stored in the cine buffer to the one or moretarget image frames; and select, without input from the operator, one ormore of the first image frames from the cine buffer for presentation tothe operator based on the comparison with the one or more target imageframes.
 2. The ultrasound imaging system of claim 1, wherein theprocessor is configured to receive an approval from the operator of apresented image frame and to mark the approved image frames forinclusion into a patient record or other report.
 3. The ultrasoundimaging system of claim 1, further comprising a memory to store the oneor more target image frames associated with the type of examination. 4.The ultrasound imaging system of claim 1, wherein the one or more targetimage frames represent previous image frames for the type of examinationperformed by the operator.
 5. The ultrasound imaging system of claim 1,wherein the type of examination is associated with a plurality ofparameters including one or more of an operating mode, a power setting,a pulse repetition rate, a focal depth, a probe type, a number of imageframes to be included in a report, one or more views desired in an imageframe, one or more measurements desired in the image frame.
 6. Theultrasound imaging system of claim 1, wherein the processor is furtherconfigured to determine an amount of target image frames for the type ofexamination.
 7. The ultrasound imaging system of claim 1, wherein theprocessor is further configured to select the one or more of the firstimage frames from the cine buffer for presentation to the operator whenthe one or more of the first image frames match to the one or moretarget image frames.
 8. The ultrasound imaging system of claim 1,wherein the processor is further configured to select the one or more ofthe first image frames from the cine buffer for presentation to theoperator when the one or more of the first image frames differ from theone or more target image frames.
 9. The ultrasound imaging system ofclaim 1, wherein the processor is configured to receive a selection ofan image frame and to display image frames that were recorded in thecine buffer at least one of before or after the selected image frame.10. The ultrasound imaging system of claim 1, wherein the one or moretarget image frames were previously selected when performing the type ofexamination.
 11. The ultrasound imaging system of claim 1, wherein theprocessor is configured to analyze the image frames stored in the cinebuffer for the presence of a defined feature and to present one or moreimage frames that contain the defined feature.